【摘要】：目的:帶狀皰疹是臨床上常見皮膚病之一,其典型的皮損及神經(jīng)痛常對患者正常的生活、工作和學(xué)習(xí)造成影響。本次研究以龍膽瀉肝湯加減聯(lián)合局部圍刺作為治療方法來觀察其對于肝經(jīng)郁熱型帶狀皰疹的臨床療效,并對其療效作出客觀評價(jià),為帶狀皰疹的防治提供參考依據(jù)。材料與方法:病例均選自2015.3-2016.3期間就診于遼寧中醫(yī)藥大學(xué)附屬第一醫(yī)院皮膚科病房的肝經(jīng)郁熱型帶狀皰疹患者,發(fā)病部位均為軀干部,共計(jì)96例,通過隨機(jī)化分組的方法將患者分為治療組與對照組,每組48例。治療組予鹽酸伐昔洛韋片聯(lián)合維生素B1、B12口服,龍膽瀉肝湯(龍膽草20g、大青葉15g、板藍(lán)根15g、梔子15g、黃芩15g、澤瀉10g、車前子10g、柴胡10g、生地10g、當(dāng)歸10g、木通10g、甘草10g)聯(lián)合局部針灸圍刺,對照組予鹽酸伐昔洛韋片聯(lián)合生素B1、B12口服,局部針灸圍刺,共治療15天,并于治療5天、10天、15天時(shí)對患者病情狀態(tài)進(jìn)行觀察并記錄評分,治療結(jié)束1個(gè)月后對完成試驗(yàn)的患者進(jìn)行隨訪,觀察兩組患者后遺神經(jīng)痛發(fā)病情況并進(jìn)行比較。結(jié)果:1.治療組在治療至第5天、第10天、第15天時(shí)分別與治療前相比較在皮損相關(guān)指標(biāo)方面其評分差異均具有統(tǒng)計(jì)學(xué)意義(P0.05),對照組在治療第5天、第10天、第15天時(shí)分別與治療前比較在皮損相關(guān)指標(biāo)方面其差異具有統(tǒng)計(jì)學(xué)意義(P0.05);在治療第5天、10天、15天時(shí)治療組與對照組相比,在皮損相關(guān)指標(biāo)方面其差異具有統(tǒng)計(jì)學(xué)意義(P0.05),由此表明治療組在對皮損的治療方面優(yōu)于對照組。2.治療組在治療第5天、10天、15天時(shí)與治療前相比較在疼痛評分方面其差異均具有統(tǒng)計(jì)學(xué)意義(P0.05),對照組在治療第5天、第10天、第15天時(shí)與治療前比較在疼痛評分方面其差異具有統(tǒng)計(jì)學(xué)意義(P0.05);在治療第5天、10天、15天時(shí)治療組與對照組相比,在疼痛評分方面其差異具有統(tǒng)計(jì)學(xué)意義(P0.05),由此表明治療組在對疼痛的治療方面優(yōu)于對照組。3.治療結(jié)束后,治療組、對照組總有效率分別為91.11%、72.72%,治療組優(yōu)于對照組。4.治療結(jié)束1個(gè)月后隨訪,治療組后遺神經(jīng)痛發(fā)病率為11.11%,對照組后遺神經(jīng)痛發(fā)病率為34.15%,表明治療組能夠有效的預(yù)防后遺神經(jīng)痛的發(fā)病。結(jié)論:1.龍膽瀉肝湯聯(lián)合局部針灸圍刺對于肝經(jīng)郁熱型帶狀皰疹的皮損及疼痛具有顯著的治療作用。2.龍膽瀉肝湯聯(lián)合局部針灸圍刺對于帶狀皰疹后遺神經(jīng)痛有著顯著的防治作用。
[Abstract]:Objective: herpes zoster is one of the common skin diseases in clinic. Its typical skin lesions and neuralgia often affect the normal life, work and study of patients. In this study, Gentian Xiegan decoction combined with local circumference was used to observe the clinical effect of Ganyan Xiegan decoction for the treatment of herpes zoster with stagnation of the liver meridian, and to make an objective evaluation of its curative effect, and to provide a reference for the prevention and treatment of herpes zoster. Materials and methods: all the patients were selected from the Department of Dermatology of the first affiliated Hospital of Liaoning University of traditional Chinese Medicine during the period of 2015.3-2016.3. Patients were randomly divided into treatment group and control group with 48 cases in each group. In the treatment group, valaciclovir hydrochloride combined with vitamin B1 B12 was given orally, and Longdan Xiegan decoction (Gentiangrass 20g, Daqingye 15g, Isatidis lanceolata 15g, Gardenia jasminoides 15g, Radix Scutellariae 15g, Radix Alismatis 10g, Plantago 10g, Radix Bupleurum 10g, Shengdi 10g, Angelica sinensis 10g, Akebia chinensis 10g) combined with local acupuncture and moxibustion. The control group was treated with valciclovir hydrochloride combined with B1B12 orally, and local acupuncture and moxibustion were used to treat the patients for a total of 15 days. The patients' state of illness was observed and scored at 5 days, 10 days and 15 days, respectively. One month after treatment, the patients who completed the trial were followed up to observe and compare the incidence of sequelae neuralgia between the two groups. The result is 1: 1. There were statistically significant differences in the scores of skin lesions between the treatment group and the pre-treatment group on the 5th, 10th and 15th day (P0.05), and the control group on the 5th, 10th, 10th day after treatment. On the 15th day, there were significant differences in the relative indexes of skin lesions between the treatment group and the control group (P0.05); on the 5th day, 10 days and 15 days after treatment, the treatment group was compared with the control group. There was significant difference in the related indexes of skin lesions (P0.05), which indicated that the treatment group was better than the control group in the treatment of skin lesions. 2. There were significant differences in pain scores between the treatment group and the control group on the 5th day and the 10th day after treatment (P0.05), and the control group on the 5th day, the 10th day, the control group on the 5th day, the 10th day after treatment, and the control group on the 5th and 10th day after treatment. There was significant difference in pain score between the 15th day and the pre-treatment day (P0.05); the treatment group was compared with the control group on the 5th day and the 10th day and the 15th day after the treatment, the pain score of the treatment group was significantly higher than that of the control group. The difference in pain score was statistically significant (P0.05), which indicated that the treatment group was better than the control group in the treatment of pain. 3. After the treatment, the total effective rates of the treatment group and the control group were 91.11 and 72.72, respectively, and the treatment group was superior to the control group. The incidence of sequelae neuralgia was 11.11 in the treatment group and 34.15 in the control group, which indicated that the treatment group could effectively prevent the incidence of sequelae neuralgia. Conclusion 1. Longdan Xiegan decoction combined with local acupuncture and moxibustion has a significant therapeutic effect on the skin lesions and pain of liver meridian heat zoster. Longdan Xiegan decoction combined with local acupuncture has a significant preventive and therapeutic effect on postherpetic neuralgia.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R275.9

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